普伐他汀对高胆固醇血症中年男性住院情况的影响：苏格兰西部冠心病预防研究

The effects of pravastatin on hospital admission in hypercholesterolemic middle-aged men: West of Scotland Coronary Prevention Study.

出版信息

J Am Coll Cardiol. 1999 Mar 15;33(4):909-15.

Abstract

OBJECTIVES

The purpose of the study was to assess the effect of lipid reduction with pravastatin on hospital admissions in middle-aged men with hypercholesterolemia in the West of Scotland Coronary Prevention Study.

BACKGROUND

A prospective, randomized controlled trial was undertaken in primary care centers in the West of Scotland.

METHODS

A total of 6,595 participants randomized to receive pravastatin 40 mg or placebo daily were followed up for a mean of 4.9 years (range 3.5 to 6.1 years). Analysis of hospital admissions was undertaken according to the "intention to treat" principle both for cardiovascular diseases and noncardiovascular diseases (including malignant neoplasms, psychiatric diagnoses, trauma and other causes). A secondary analysis of hospitalization in patients who were > or = 75% compliant was performed.

RESULTS

During the trial, 2,198 (33%) of the 6,595 men were admitted to hospital on 4,333 occasions, of which 1,234 (28%) were for cardiovascular causes. Pravastatin reduced the number of subjects requiring hospital admission for cardiovascular causes by 21% (95% CI [confidence interval] 9 to 31, p = 0.0008) overall, and by 27% (95% CI 15 to 38) in compliant participants. The number of admissions per 1,000 subject-years for cardiovascular disease was reduced by 10.8 (95% CI 4 to 17.4, p = 0.0013) in all subjects, and by 15.6 (95% CI 8.3 to 23, p < 0.0001) in compliant participants. Pravastatin had no significant influence on hospital admission for any noncardiovascular diagnostic category. There were 13.4 fewer admissions per 1,000 subject-years for all causes in the pravastatin-treated group (95% CI -0.4 to 27.3, p = 0.076). No significant difference in duration of hospital stay was found between the pravastatin and placebo patients in any diagnostic group.

CONCLUSIONS

Pravastatin therapy reduced the burden of hospital admissions for cardiovascular disease, without any adverse effect on noncardiovascular hospitalization.

摘要

目的

本研究旨在评估在苏格兰西部冠心病预防研究中，普伐他汀降脂治疗对中年高胆固醇血症男性患者住院率的影响。

背景

在苏格兰西部的基层医疗中心开展了一项前瞻性随机对照试验。

方法

总共6595名随机接受每日40毫克普伐他汀或安慰剂治疗的参与者，平均随访4.9年（范围3.5至6.1年）。根据“意向性治疗”原则，对心血管疾病和非心血管疾病（包括恶性肿瘤、精神疾病诊断、创伤及其他原因）的住院情况进行分析。对依从性≥75%的患者的住院情况进行了二次分析。

结果

在试验期间，6595名男性中有2198人（33%）共住院4333次，其中1234次（28%）是因心血管原因。总体而言，普伐他汀使因心血管原因需要住院的患者人数减少了21%（95%置信区间[CI]9至31，p = 0.0008），在依从性好的参与者中减少了27%（95%CI 15至38）。所有受试者中，每1000人年的心血管疾病住院次数减少了10.8次（95%CI 4至17.4，p = 0.0013），在依从性好的参与者中减少了15.6次（95%CI 8.3至23，p < 0.0001）。普伐他汀对任何非心血管诊断类别的住院情况均无显著影响。普伐他汀治疗组每1000人年的所有原因住院次数减少了13.4次（95%CI -0.4至27.3，p = 0.076）。在任何诊断组中，普伐他汀组和安慰剂组患者的住院时间均无显著差异。